A resident’s advice on Match ranking: You are in control

The Match ranking process opened Jan. 15. As medical students consider their options ahead of the Feb. 22 deadline for certifying their rank-order lists, a third-year resident shares his insights into the ranking thought process. The point on which he is most adamant: The choice is yours.

“The biggest thing with the Match is, at the end of the day, you’re in control,” said Chirag Shah, MD, an anesthesiology and critical care resident at University of Chicago Medicine. “If you don’t like a program, you don’t have to rank it. And you’d probably be better off not ranking a program you don’t like instead of doing your residency there and being unhappy for three, four, five, six years.”

Cultivating work-life balance was one of Dr. Shah’s top priorities when scouting and ranking programs. He even treated the interview process as a “fourth-year farewell,” taking more than 30 interviews in cities across the country and using the trips to catch up with friends and consider his social prospects in each location.

“Work-life balance should be very important to you as an applicant,” he said. “You want to have a life where you can focus on activities outside of the hospital. Clinical experience is important, but your personal life is also important. I focused on big cities because I wanted to meet people, go out, socialize. I had learned from my time in the workforce before medical school how important those things were to me.”

Windy City calls

By the time he was submitting his Match ranking list, he had been away from his family in Chicago for more than ten years. After college, he went to work in New York and then attended medical school at Case Western Reserve University School of Medicine, in Cleveland.

“When I left home, my parents were 53, 54. Now they’re 64, 65,” Dr. Shah said. “They have medical issues. They have life issues. They’re getting older and they’re not as sturdy. I feel like it’s an important time to catch up with them.”

He also considered how his social life could buttress his learning experience.

“You need a good support structure, whether it’s friends, your family or even your fellow residents,” he explained. “You’re going to have some sort of a setback—everyone does. If you don’t have that support structure, you might struggle more than you need to.”

So when it came time to finalize his Match ranking list, he ordered programs geographically, beginning with those in Chicago.

“I only ranked programs in major cities, but I included each program in each of those cities,” he said. “I ranked Chicago programs first, then all the programs in Boston, then San Francisco. I thought, ‘Chicago is where I’m going to be happiest for the next four, five, six years. This is where I want to be.’”

He acknowledged his approach to ranking was a bit unconventional, especially given the pressure to reach for the most prestigious programs.

“Everyone gets caught up in the name game,” he said. “It’s very easy to think, ‘Everyone says this is the best program in the world, and you’re so lucky to interview there. How could you not rank it No. 1?’ That’s a very easy trap to fall into, because you’re in this rat race and everything’s competitive. You really have to get beyond that and think about where you’re going to be happiest. Because the best program in the world, according to the experts, might not be the best program for you.”

Still, he said, medical students are assured of getting sufficient training no matter the program with which they are matched.

“At the end of the day, 99 percent of the programs are the same because of ACGME accreditation,” he noted. “You’re going to get pretty much the same range of experience—there will be some differences on the periphery—but the thing to look at is whether you’re going to be happy with your colleagues.”

Three years after matching, he stands by his ranking decisions. He recently got engaged, and he credits his residency program with giving him the chance to meet his future spouse.

“Remember, you have a say. You’re no longer under your school’s command,” he said. “You get to say where you would be happiest. You have a lot of power as a fourth-year medical student.”

More on Match

Check out other Wire posts for additional insights from residents and fellows. Follow #Match2017 on Twitter to see where other students matched and check out #MatchThrowback for pictures submitted by residents showing their Match Day celebrations. The National Resident Matching Program will host a Twitter chat on Tuesday, Jan. 24, from 2 – 3 p.m. Eastern Standard Time. Join by using the #ROL2017 hashtag.